Controversies in Acute Pancreatitis

362 Pages·1982·22.49 MB·English

by  J. Delmont

Controversies
in Acute Pancreatitis
Edited by L.F. Hollender
With-87 Figures and 124 Tables
Springer-Verlag
Berlin Heidelberg New York 1982
International Symposium "Controversies in acute pancreatitis"
Strasbourg, 12.-13. June 1981
Prof. Dr. med., Dr. h.c. L.F. Hollender
Service de Chirurgie Generale 1 et de Chirurgie Digestive
Centre Hospitalier Universitaire de Strasbourg Hautepierre
F-67098 Strasbourg Cedex
ISBN -13:978-3-540-11410-9 e-ISBN-13 :978-3-642-68518-7
DOl: 10.1007/978-3-642-68518-7
Library of Congress Cataloging in Publication Data
International Symposium "Controversies in Acute Pancreatitis"
(1981 : Strasbourg, France) Controversies in acute pancreatitis.
Bibliography: p.
Includes index.
1. Pancreatitis-Congresses. I. Hollender, L.F., 1922· . II. Title.
[DNLM: 1. Pancreatitis-Congresses. 2. Acute disease-Congresses.
WI 805161c 1981]
RC858.P35I57 1981 616.3'7 82-3348
ISBN-13:978-3-S40-11410-9 (U.S.) AACR2
This work is subject to copyright. All rights are reserved, whether the whole or part
of the material is concerned, specifically those oftranslation, reprinting, reuse of il
lustrations, broadcasting, reproduction by photocopying machine or similar
means, and storage in data banks.
Under § 54 of the German Copyright Law where copies are made for other than pri
vate use, a fee is payable to Verwertungsgesellschaft Wort, Munich.
© by Springer-Verlag, Berlin Heidelberg 1982
The use of registered names, trademarks, etc. in this publication does not imply,
even in the absence of a specific statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general use.
Composition: FotoSatz Pfeifer, Germering
2124/3321 543210
Contents
L.F. Hollender. Preface ..................... XVII
J. Delmont, J.P. Vedel, X. Faure, G. Vauban and A. Harris. Does
Incompetence of the ~phincter of Oddi Exist? Can It Account for
Certain Cases of Acute Pancreatitis? . . . . . . . . . . . . . . 1
A.A. Arianoff. Pancreatic Duct Reflux and Acute Pancreatitis 7
P .H. Larrieu and H.A. Bec1ere. Can Pancreaticoduodenal
Reflux Explain Acute Pancreatitis? Yes, in Some Cases . 9
J. Mouiel, J.C. Bertrand, P. Mazarguil, J.P. Vedel and M.
Loubiere. The Role of Biliary Millilithiasis in the Pathogenesis
of Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . .. 11
G. Bevilacqua, O. Chiara, L. Bigatello, A. Bizzi and A. Nespoli.
Hemodynamic and Metabolic Impairment in Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . .. 18
M. Carboni, P. Negro, G. de Bemardinis, D. Tuscano, G. Flati
and D. Flati. Acute Pancreatitis Following Transduodenal
Sphincterotomy . . . . . . . . . . . . . . . . . . . . . . . .. 31
G.L. Nardi. Discussion 37
A. De1court. Controversies in the Biological Diagnosis of Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . .. 38
G. Jacobson, U. Hedstrand and B. Nilsson. The Cause of
Hypophosphatemia in Acute Pancreatitis . . . . . . . . 45
G. Pott, T. Krummenerl, J. Lohmann and M. Clemens.
Fibronectin as a Prognostic Parameter in Patients Suffering from
Pancreatogenic Shock . . . . . . . . . . . . . . . . . . . . 48
R.E.C. Collins and K. Spittlehouse. The P Index in Acute
3
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . 50
M.J. McMahon. The Amylase to Creatinine Clearance
Ratio ......................... . 51
v
P. Metais, P.L. Arzoglou and G. Ferard. Interest of
Measuring Plasmatic and Urinary Lipase Activity in Pancreatic
Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . .. 54
F.S. Weill. Ultrasonic Diagnosis of Acute Pancreatitis 59
J. Pringot, A.N. Dardenne, J.P. Lousse, M. Reynaert and
P.J. Kestens. Contribution of Computed Tomography in the
Diagnosis of Severe Acute Pancreatitis . . . . . . . . . . 64
B. Braun. Possibilities and Limits of Sonography in Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . 70
H.G. Dammann, E. Grabbe, H.P. EichfuB and D. Flashoff.
Computed Tomography and Clinical Severity of Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . 72
C. Benameur, D. Larde, E. Lepresle, P.L. Fagniez and
N. Vasile. Computed Tomography and Acute Pancreatitis 78
A. Rohner and H. Hauser. Computer Tomography and
Prognostics of Acute Pancreatitis . . . . . . . . . . . . 81
I. Staib, L. Mihaljevic and G. Siemoneit. Retrospective Value
of Diagnostic Procedures in Acute Pancreatitis . . . . 84
M. Guntz, C. Caron-Poitreau, M. Vialle, P. Cronier,
R. Taviaux and H. Francois. Computed Tomography and
Anatomical Comparisons in Acute Pancreatitis . . . . . . 86
K.J. Klose. Possibilities and Limits of Computed
Tomography ................. . 92
P. Aeberhard, P. Vock and A. Keller. Contribution of
Computed Tomography in the Management of Acute
Necrotizing Pancreatitis ............... . 95
M.J. McMahon. Peritoneal Lavage for the Diagnosis and
Prognosis of Acute Pancreatitis . . . . . . . . . . . . . . . . . . 106
G. Dagnini. What can be Expected of Laparoscopy in the
Diagnosis of Acute Pancreatitis? . . . . . . . . . . . .. ... 110
J.H.C. Ranson. Objective Prognostic Evaluation of Patients
with Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . . . 112
H.G. Dammann, H.P. EichfuB, H.v. Laer and M. D6pner.
Prognostic Signs in Acute Pancreatitis .............. 119
VI
G. Guillemin, P. Berard, H. Labrosse, B. Robin and
J.P. Carabalona. Prognostic Value of Nystagmus in the
Evolution of Acute Pancreatitis . . . . . . . . . . . .. .... 124
L. Leger, B. Chiche, P. Moulle and A. Louvel. Pancreatic
Necrosis and Acute Pancreatitis. . . . . . . . . . . . . . .. 127
G.C. Castiglioni, I. Giovannini, M. Pittiruti, G. Boldrini and
M. Castagneto. Functional Cardiorespiratory Patterns in Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . 133
P. Testas, M.O. Bitker, M. Lautard, A. Vieillefond and
M. Fabre. Technical collaboration: S. Crougneau, M. Sissung
and A. Rault. Histopathology of Experimental Pancreatitis of
Ductal Origin . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
P. G. Lankisch. Current Status of Diagnosis and Conservative
Treatment of Acute Pancreatitis ................. 143
M. Wanke. Anatomopathological Findings in Acute
Pancreatitis . . . . . . . . . . . . . . . . . .. . . . . . . . 152
M.F. Vankemmel. Acute Necrotic Pancreatitis:
Anatomosurgical Correlations and Therapeutic Deductions . 160
P.A. Jones, D.A.W. Grant and J. Hermon-Taylor. Proteinase
Inhibitors of Microbial Origin in the Treatment of Experimental
Acute Haemorrhagic Pancreatitis . . . . . . . . . . . . . . . . . 163
E.P. Dimagno. Relationship of Glucagon to Exocrine
Pancreatic Secretion and Its Use in Acute Pancreatitis ... 166
K.H. Usadel, U. Leuschner and K.K. Obeda. Treatment of
Acute Pancreatitis with Somatostatin. A Randomized Study . 167
J .C. Laporte and J. Hureau. Trypsinogen and Trypsin in Acute
Pancreatitis. Physiopathology . . . . . . . . . . . . . . . . .. 171
H. Becker, W. Ruf, W. Hissen and K. Junghanns. A Prospective
Study to Determine the Efficacy of Dextran 40 in Acute
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . 175
L.F. Hollender, C. Meyer, A. Marrie, J.S. Costa da Silva
and G. Papastratis. Our Experience in the Treatment of Acute
Necrotizing Hemorrhagic Pancreatitis ........... 181
R.P. Buffin. Acute Pancreatitis: Results of 42 Observations 185
VII
J. Puig La Calle and J. Lopez Gibert. Acute Pancreatitis.
Retrospective Study of 225 Cases . . . . . . . . . . . . . 187
R. Colin. Points of View on Necrosis in Acute Pancreatitis 190
M. Cooperman. Peritoneal Lavage in Acute Pancreatitis . 193
F.P. Gall and C. Gebhardt. Our Experience with Drainage-
Lavage of the Peritoneal Cavity. . . . . . . . . . . . . . . 196
I.Ihse, A. Evander and I. Gustafson. A Controlled Randomized
Study on the Value of Peritoneal Lavage in Acute Pancreatitis
(an Interim Report) . . . . . . . . . . . . . . . . . . . . . . 200
M.J. McMahon. Therapeutic Peritoneal Lavage 203
M. Reynaert, M. Van Maele, J.M. Gouverneur, J.B. Otte,
J. Tremouroux and P.J. Kestens. Peritoneal Dialysis in Acute
Necrotic-Hemorrhagic Pancreatitis . . . . . . . . . . . . . 206
D. Maroske. Acute Hemorrhagic-Necrotic Pancreatitis:
Laparotomy or Peritoneal Lavage? Results of a Randomized
Controlled Clinical Study . . . . . . . . . . . . . . . . . . . 209
L. Safrany. Controversies in Acute Pancreatitis 214
G. Kautz, G. Wittrin and F. Zastrow. Endoscopic Papillotomy
as a Therapeutic Alternative in Acute Biliary Pancreatitis. . 219
N. van Husen. Endoscopic Sphincterotomy in Acute Biliary
Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
R.M. Bory and R. Lambert. Endoscopic Sphincterotomy in
Acute Pancreatitis ... 229
F. Kiimmerle and H. Sch6nborn. Possibilities and Limits of
Intensive Care in Acute Necrotic Pancreatitis. . . . . . .. . 231
M. Rapin. Controversies in Possibilities and Limits of Intensive
Care. Conclusions . . . . . . . . . . . . . . . . . . . . . .. . 236
A. Akovbiantz. Acute Pancreatitis: Controversial Operative
Indications ......................... .. 237
A. Fritsch, J. Funovics, N. H6lbling, P. Sporn, W. Mauritz,
G. Z6ch and J. Karner. Our Criteria for Surgical Intervention
in Acute Necrotizing Pancreatitis . . . . . . . . . . . . . . . . . 239
VIII
G. Jacobson. Controversies in Surgical Indications . . . . . . . . 245
P. Boutelier and G. Edelmann. Results of Exeresis in Acute
Necrotico-hemorrhagic Pancreatitis . . . . . . . . . . . . 246
G.c. Bressan. Choice of Treatment in Acute Pancreatitis 249
P. Vayre, J. Hureau and J.L. Jost. Surgical Treatment of Acute
Necrotizing Pancreatitis: A Series of 30 Cases . . . . . . . 252
P.J. Kestens, J.B. Otte, E. Wibin, M. Timmermans,
M. Reynaert and J. Haot. Surgical Treatment of Acute
Necrotizing Hemorrhagic Pancreatitis: A Series of 46 Cases . . . 254
B. d'Almeida. Acute Pancreatitis: Conservative Attitude,
Expectant Vigilance . . . . . . . . . . . . . . . . . .. .... 260
W. Ruf, H. Becker, W Hissen and K. Junghanns. Acute
Pancreatitis: Results and Strategy of Operative Treatment . . . . 266
J.H. Alexandre, M.T. Guerrieri, J.J. Susini, M. Sage,
J.P. Fraioli, B. Leger and L. Morand. Role of Total
Pancreatectomy in the Treatment of Acute Necrotizing
Pancreatitis. Indications and Results of 22 Cases . .. ..... 272
P.J. Verhaeghe, M.J. Riboulot, M.J. Malgouzou and
R.E. Stoppa. Early and Iterative Interventions in Cases of
Acute Necrotizing Pancreatitis: An Answer to the Absence of
Correlation Between Their Anatomical and Clinical
Expressions . . . . . . . . . . . . . . . . . . . . . . . . .. . 280
P. Maillet. Enteral Nutrition by Alimentation Jejunostomy in 11
Cases of Severe Acute Pancreatitis . . . . . . . . . . . . . . 283
P. Bazan, G. Agnello and V. Lanza. The Role of Artificial
Nutrition in the Treatment of Acute Pancreatitis . . . . . . 288
G. Motton, C. Pistorelli, G. Fracastoro, C. Cordiano,
P. Pederzoli, C. Bassi, T. Pilon and S. Modena. Role of
Complete Parenteral Treatment Nutrition in Acute Pancreatitis . 293
N. H6lbling, J. Funovics, E. Roth, J. Kamer, G. Z6ch and
A. Fritsch. Amino Acid Metabolism in Acute Necrotizing
Pancreatitis. Aspects of Parenteral Nutrition . . . . . . . . . 297
M. Carboni, P. Negro, D. Tuscano, G. de Bemardinis, D. Flati
and G. Flati. Secondary Colonic Lesions in Acute Pancreatitis. 302
IX
J.P. Palot, M. Pluot, J.F. Delattre, J.B. Flament and J. Rives.
Necrotizing Colitis and Acute Necrotizing Pancreatitis.
Report of Eight Cases. Role of Shock. . . . . . . . . . . . . . . 316
M. Cooperman. Problems in the Management of Pancreatic
Abscesses . . . . . . . . . . . . . . . . . . . . . . . . . . 324
R. Botticher. Treatment of Pancreatic Abscess 327
J. Waninger. Treatment of Fistulas Following Laparotomy
for Acute Pancreatitis . . . . . . . . . . . . . . . . .. .... 328
M. Mercadier. General Conclusions and Adoption of a
Diagnostic and Therapeutic Programme for the Future . 330
Subject Index . . . . . . . . . . . . . . . . . . . . . . 341
x
List of Authors
Dr. P.Aeberhard
Klinik fUr Viszerale Chirurgie, Inselspital, 3010 Bern, Switzerland
Prof. A. Akovbiantz
Chirurgische Klinik, Stadtspital Waid ZUrich, Tiechestrasse 99, 8037 Zu
rich 10, Switzerland
Prof. J. H. Alexandre
Hl)pital Broussais, 96 Rue Didot, 75014 Paris, France
Dr. A. Arianoff
Cliniques Ste.Elisabeth, Avenue de Fre 45, Bruxelles, Belgium
Prof. P. Bazan
Via Marchese di Villabianca 175, 90100 Palermo, Italy
Dr. H. Becker
Chirurgische Klinik, Klinikum der Universitat Heidelberg, 1m Neuen
heimer Feld 110, 6900 Heidelberg 1, FRG
Prof. V. Becker
Pathologisches Institut der Universitat Erlangen-Nurnberg, Kranken
hausstrasse 8 -10, 8520 Erlangen, FRG
Dr. C. Benameur
Service d'Electro-Radiologie, Hl)pital Henri-Mondor, 51 Avenue du
Marechal de Lattre de Tassigny, 94010 Creteil, France
Prof. G. Bevilacqua
Cattedra di Chirurgia d'Urgenza, Istituto di Clinica Chirurgica Generale
e Terapia Chirurgica I, Via F.Sforza 33, 20122 Milano, Italy
Dr. R. Bory
Service d'Hepato-Gastro-Enterologie, Hl)pital Edouard Herriot, Place
d' Arsonval, 69374 Lyon Cedex, France
Prof. R. Botticher
Chirurgische Klinik 1, Stadtkrankenhaus Furth, Jacob-Henle-Strasse 1,
8510 Furth, FRG
Prof. J. Borges d' Almeida
Consultorio Medico, 234 Avenida da Liberdad, R-C Lisbon, Portugal
XI